New life support quiz – The Emergency Medicine Manual

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Created on November 16, 2025 By Bob Dunn

Life support

BLS and ALS

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1. In adult cardiac arrest with a shockable rhythm adrenaline should first be given

a) Immediately on recognition of cardiac arrest

b) 6 minutes after CPR has commenced

c) 2 minutes after CPR has commenced

d) 4 minutes after CPR has commenced

In adult cardiac arrest with a shockable rhythm adrenaline should first be given 2 minutes after CPR has commenced.

In adult cardiac arrest with a shockable rhythm adrenaline should first be given 2 minutes after CPR has commenced.

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2. Match the drug doses with the following agents used in paediatric cardiac arrest

1. Adrenaline

2. Atropine

3. Lignocaine

4. Amiodarone

The correct paediatric doses are:
Adrenaline 10 microg/kg
Atropine 20 microg/kg
Amiodarone 5mg/kg
Lignocaine 1 mg/kg

The correct paediatric doses are:
Adrenaline 10 microg/kg
Atropine 20 microg/kg
Amiodarone 5mg/kg
Lignocaine 1 mg/kg

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3. The preferred initial sequence of management of pulseless electrical activity is which one of the following:

a) Commence CPR / obtain IV access / administer atropine 1mg / check for treatable causes / perform endotracheal intubation / administer adrenaline every 4 minutes

b) Obtain IV access / perform endotracheal intubation / commence CPR / administer adrenaline 1mg / repeat adrenaline every 4 minutes / check for treatable causes

c) Check for treatable causes / commence CPR / obtain IV access / perform endotracheal intubation / administer adrenaline 1mg / repeat adrenaline every 4 minutes

d) Commence CPR / obtain IV access / administer adrenaline 1mg /check for treatable causes / repeat adrenaline every 4 minutes/ perform endotracheal intubation

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4. Pulseless VT comprises approximately what percentage of shockable rhythms in out of hospital cardiac arrest in adults?

a) 30%

b) 20%

c) 10%

d) 2%

Pulseless VT comprises approximately 1-2% of shockable rhythms in out of hospital cardiac arrest in adults. So shockable rhythms are nearly all VF.

Pulseless VT comprises approximately 1-2% of shockable rhythms in out of hospital cardiac arrest in adults. So shockable rhythms are nearly all VF.

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5. The estimated circulation time of drugs given in cardiac arrest with CPR in progress is

a) 90 seconds

b) 60 seconds

c) 30 seconds

d) 15 seconds

The estimated circulation time of drugs given in cardiac arrest is about 90 seconds with CPR in progress.

The estimated circulation time of drugs given in cardiac arrest is about 90 seconds with CPR in progress.

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6. The appropriate compression : relaxation ratio for chest compressions in BLS in adults is

a) 1:1

b) 1.5:1

c) 1:2

d) 2:1

The appropriate compression : relaxation ratio for chest compressions in BLS in adults is 1:1.

The appropriate compression : relaxation ratio for chest compressions in BLS in adults is 1:1.

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7. During CPR, the effectiveness of the operator performing chest compression usually starts to reduce between

a) 2-3 min

b) 0-1 min

c) 3-4 min

d) 1-2 min

A 10-20% reduction in compression depth occurs by 90 sec., despite operators not necessarily feeling fatigued. This is the reason that changing operators at least every 2 minutes (usually at the time of rhythm check) is required.

A 10-20% reduction in compression depth occurs by 90 sec., despite operators not necessarily feeling fatigued. This is the reason that changing operators at least every 2 minutes (usually at the time of rhythm check) is required.

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8. Which one of the following statements regarding drug therapy in ALS for shockable rhythms is correct

a) Amiodarone and lignocaine are similarly effective

b) Amiodarone is superior to lignocaine

c) Lignocaine is superior to amiodarone

d) Amiodarone and lignocaine are highly effective

In shockable rhythms that have failed defibrillation attempts and adrenaline, lignocaine and amiodarone are considered of equal (but low) effectiveness.

In shockable rhythms that have failed defibrillation attempts and adrenaline, lignocaine and amiodarone are considered of equal (but low) effectiveness.

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9. Regarding cardiac arrest following poisoning which one of the following statements is incorrect:

a) Diazepam and adrenaline are antidotes for chloroquine toxicity

b) HCO3 therapy may be indicated

c) Naloxone is an antidote for clonidine toxicity

d) The prognosis for most patients with poisoning is worse than that of older patients with cardiogenic cardiac arrest

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10. The most appropriate sedation agent for a patient with VF about to be defibrillated but who is still aware during CPR is

a) Midazolam

b) Propofol

c) Nothing

d) Ketamine

The most appropriate sedation agent for a patient with VF who is still aware during CPR is nothing. Whilst this may seem harsh, the delay to administration of any agent (allowing for circulation time) will decrease the probability of survival too much to justify.

The most appropriate sedation agent for a patient with VF who is still aware during CPR is nothing. Whilst this may seem harsh, the delay to administration of any agent (allowing for circulation time) will decrease the probability of survival too much to justify.

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11. Regarding endotracheal drug delivery which one of the following statements is incorrect:

a) 5 - 10 forceful ventilations should be given following endotracheal drug delivery

b) Amiodarone may be delivered via the endotracheal tube

c) Endotracheal drug delivery delivers a significant decrease & delay in peak serum levels compared with IV administration

d) It should only be used if IV access is unable to be obtained after 5 minutes

Amiodarone cannot be given via ETT.

Amiodarone cannot be given via ETT.

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12. In an adult patient with cardiac arrest, defibrillation pads should be placed

a) Anterior posterior - with anterior being negative

b) Anterior posterior

c) Basal posterior

d) Apical basal

In an adult patient with cardiac arrest, defibrillation pads should be placed apical basal. Anteroposterior placement would require interruption of CPR, which should be avoided.

In an adult patient with cardiac arrest, defibrillation pads should be placed apical basal. Anteroposterior placement would require interruption of CPR, which should be avoided.

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13. In an adult patient with witnessed, monitored, in hospital cardiac arrest due to VF which one of the following strategies is most likely to obtain ROSC?

a) 3 stacked shocks, 1mg adrenaline then 2 minutes of CPR if ineffective

b) Immediate single defibrillation, then 2 minutes of CPR if ineffective

c) 2 minutes of CPR then defibrillation

d) CPR until defibrillator ready, 3 stacked shocks, then 2 minutes of CPR if ineffective

In an adult patient with witnessed, monitored, in hospital cardiac arrest due to VF, CPR until defibrillator ready, 3 stacked shocks, then 2 minutes of CPR if ineffective is the strategy most likely to obtain ROSC. According to ILCOR guidelines (as of 2025) this strategy should be considered, but evidence suggests it is superior to the out of hospital cardiac arrest algorithm.

In an adult patient with witnessed, monitored, in hospital cardiac arrest due to VF, CPR until defibrillator ready, 3 stacked shocks, then 2 minutes of CPR if ineffective is the strategy most likely to obtain ROSC. According to ILCOR guidelines (as of 2025) this strategy should be considered, but evidence suggests it is superior to the out of hospital cardiac arrest algorithm.

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14. In advanced prehospital systems such as Australia and New Zealand, the median time to defibrillation for shockable rhythms is approximately

a) 10 minutes

b) 4 minutes

c) 12 minutes

d) 7 minutes

In advanced prehospital systems such as Australia and New Zealand, the median time to defibrillation for shockable rhythms is approximately 7 minutes. This means there is significant organ hypoxia and acidosis that is not present in in hospital witnessed cardiac arrests.

In advanced prehospital systems such as Australia and New Zealand, the median time to defibrillation for shockable rhythms is approximately 7 minutes. This means there is significant organ hypoxia and acidosis that is not present in in hospital witnessed cardiac arrests.

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15. Common causes of spurious rhythms may include all of the following except:

a) Shivering may mimic ventricular fibrillation

b) Very fine VF can be misinterpreted as asystole

c) Coarse Parkinsonian tremor can mimic atrial flutter

d) Deep breathing may mimic complete heart block

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